Medicare’s open enrollment periods have ended, and you won’t have another chance to change plans this year. Your next opportunity will be the fall Annual Enrollment Period (AEP) when you can change your plan for 2026. If you didn’t take advantage of last year’s AEP, you may find you are stuck in plan that costs too much or doesn’t offer the benefits you need. Here’s why it’s a good idea to consult with a Medicare agent every year.
Plans Change Each Year
Each year, insurance carriers are allowed to update their plans for the coming plan year. As a Medicare enrollee, you should receive a notice about any changes to your Medicare Advantage or Medicare Part D plan in September. This notice is called the Annual Notice of Change, and it can include important information about upcoming changes to your benefits and costs.
Unfortunately, these changes may mean that your plan is no longer a good fit for you. These can include:
- Increases to out of pocket costs including the monthly premium, deductibles, copays, and coinsurances
- Changes to the drug formulary which could change the cost of a medication or remove it entirely from the formulary
- Changes to the provider network that could impact your ability to see your preferred physicians and hospitals
- Negative changes to benefits including removal of a benefit or special limitations or requirements
Thankfully, you have other options. The annual enrollment period is your chance to shop around.
Other Plans May Be More Attractive
If your plan isn’t changing, or if you are OK with the changes, you may think that there’s no reason to shop around. This can be a mistake.
Changes don’t just impact your plan. Other plans may be changing, too, and these changes could make the other plans more attractive.
For example, let’s say that when you enrolled in your plan, you were considering two different but very similar plans. You would have been happy with either. Now the other plan is adding a new benefit, while your plan has stayed the same. Before, the plans were about equal, but now, the other plan is much better for your needs. It makes sense to switch.
Your Annual Notice of Change only includes information about your plan. It doesn’t tell you about changes in other plans that might be appealing to you. If you want to learn about these changes, you need to shop around during the annual enrollment period.
New Plans Enter the Market and Some Existing Plans May Leave
Every year, new plans become available as carriers enter the Medicare market and expand into new areas. If there are new plans in your region, it makes sense to take a look at them. Even if you’re happy with your current plan, you might find that you’d be even happier with one of these new plans. Conversely some insurers may choose to terminate plans in some areas. If your plan is discontinued you will receive notification and you will need to find new coverage during AEP.
Your Reasons for Selecting a Plan May No Longer Apply
Even if your costs and benefits have stayed the same, the reasons you initially had for selecting your plan may no longer apply.
For example, you may have chosen a more expensive PPO plan because you traveled a lot and wanted to have access to out of network coverage while you were away. Now you plan to stay closer to home and a less costly HMO plan will meet your needs. Shopping for a new plan could save you money.
You Might Qualify for a Special Enrollment Period
Medicare will allow you to change plans outside of its main enrollment periods if your circumstances have changed, or when certain life events occur. A Medicare agent can help you determine if you qualify for a Special Enrollment Period.
Obtain Peace of Mind
It’s never too early to start thinking about AEP. Take time to evaluate your current plan benefits during the year to help you decide if it is still the best plan for your needs. Remember, you’re not required to switch. You can keep your current plan, confident that it really is the right one for you.
If you don’t shop around, you can still keep your plan, but you might not be so confident. Whether or not you decide to switch, preparing to shop around during fall AEP can give you peace of mind throughout the next year.
It doesn’t need to be difficult, either. An insurance agent can help you assess your needs and suggest plans that you might be interested in. It won’t take much of your time, and you could save money and get better coverage as a result.
Do you need help reviewing your Medicare plan options? Get in touch with Healthcare Educators.